Self-medication is an age old practice. Urge of self care, feeling of sympathy towards family members in sickness, lack of health services, poverty, ignorance, misbeliefs, extensive advertisement and availability of drugs in other than drug shops are responsible for growing trend of self-medication. WHO is promoting practice of self-medication for effective and quick relief of symptoms without medical consultations and reduce burden on health care services, which are often understaffed and inaccessible in rural and remote areas[1] .

William Osler has said that "A desire to take medicine is perhaps the great feature which distinguishes man from animals" This desire, however may play havoc when a person starts taking medicines on his own, forgetting that all drugs are toxic and their justifiable use in therapy is based on a calculable risk. It is said that every patient has at least two prescribers his own doctor and himself, while many have additional prescribers in the from of friends, well wishers etc. Present study was carried out to investigate the problem and factors responsible for this practice in Rural area of Karad taluka in Western Maharashtra.

Material & Methods

Present study was carried out in rural field practice area of Krishna Institute of Medical Sciences, Karad. Out of three, one village Jakhinwadi was selected having population of 4353. All 515 households in that village were included in the study. Definition of self-medication used was "Medication that is taken on patient's own initiative or on advice of a pharmacist or lay person"[2] . Heads of family were interviewed using pre-tested questionnaire. Out of 515 households in the village 12 could not be contacted due to various reasons. Help of social workers and village leaders was taken to seek cooperation. Data was analyzed and suitable tests of significance were applied.

Results

Majority (63.0%) of the respondents were in age group 36-55 years. As only heads were interviewed most of them were males. 42% were illiterate & majority of them belonged to class IV (43.17%). Prevalence of self medication was found among 81.5% individuals. 48.78% were practicing self medication for last 5 years and 38.53% for more than 5 years. This may be due to increased advertisement and availability of drugs during last decade.

Major reasons for practicing self medication were economic (58.5%) or non availability of health care facility (29.3%). Advertisement in newspaper, TV, Radio and magazines were main sources of information (32.93%), followed by chemist shops (25.61%).

Major sources of procurement of drugs were chemist shop (36.1%) and other shops (54.18%) including pan shop, grocery shop etc. Most of the users of self-medication resorted to Allopathic system of medicine (73.17%), 9.76% were using allopathic + others and 9.02% only Ayurvedic medicines. We found that 80.49% respondents used self-medication mainly for the treatment of minor illness such as headache, cough, fever. Very few (6.34%) had knowledge about correct use and only (19.5%) users had knowledge about side effects. Analgesics, antipyretics and anti-diarrhoeals were most commonly used drugs.

Discussion

Various studies carried out show a range of self-medication practices between 15% to 65%.[2] ,[3] In this contrast our study revealed a prevalence of 81.51% which is much higher. Reasons for wide variations may be due to differences in education, socio-economic status, non-availability of medical facilities and easy availability of drugs.

In studies by Durgawale in urban slum and Saeed et al self­medication practice was due to economic reasons among 60.53% and 86% respectively.[2] ,[3] In our study it was responsible for 58.54%. Non-availability of medical facilities and faith in traditional system were the other reasons.

Allopathic medicine was used by 73.17% respondents which is consistent with studies carried out by Kumar 69% and Durgawale (78.95%).[4] ,[3] Major source of information in our study was through advertisement which is consistent to study carried out by Pendse[5] . Left over drugs are suggested to be common source of drugs used in self medication by Pendse5.Our study revealed that 54.18% respondents procured drug from other shops and 36% from drug stores. This highlights that legislative implementation in banning advertisement and sale over the counter drugs without doctor's prescription. Provoking mass media activities by newspapers, radio, T.V, posters, messages at public places should be ckecked. IEC activities should be strengthened to let know people about hazards of self-medication and for availing health services from Government which is free of cost.

In conclusion, though self-medication if promoted by WHO because of affordability and inaccessibility of health services in developing world, benefits must be weighed against adverse effects.